title: Assessment of the effect of surgery on the kinetics of circulating tumour cells in patients with operable breast cancer based on cytokeratin-19 mRNA detection.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effect of surgery on the kinetics of CTCs in breast cancer patients.
  
  
  METHODS
  The detection of CK-19 mRNA-positive CTCs in the blood by RT-PCR was analysed in 104 stage 0-IIIA patients at 4 time-points: prior to surgery, upon completion, 24 h after surgery and 15 days after surgery. Furthermore, a late sample was assessed prior to initiation of adjuvant chemotherapy in a subgroup of 53 patients. As negative controls, peripheral blood was obtained from 50 female patients undergoing excision of benign breast lesions and from 11 female patients receiving surgery for early-stage colorectal cancer.
  
  
  RESULTS
  A significant percentage of blood samples from breast cancer patients (14.4%) were negative for CK-19 preoperatively but turned transiently positive early postoperatively. However, no significant difference in CK-19 mRNA detection was noted among the first 4 examined time-points. There was no significant correlation between CK-19 mRNA-positive cells and classic prognostic factors. A significant increase in CK-19 mRNA-positivity (32.1%) was observed in a late sample of the subgroup of 53 patients before adjuvant chemotherapy after a median of 54 days, postoperatively.
  
  
  CONCLUSIONS
  Surgery may result in CTC detection in a small proportion of early breast cancer patients. There is no clear correlation to indicate which patients are expected to have detectable CTCs. Although CTCs are detected in a small proportion of patients during the perioperative period, the detection rate may increase over time and with longer follow-up.
authors.affiliation: Department of Surgical Oncology, University General Hospital of Heraklion, School of Medicine, University of Crete, PO Box 1352, Heraklion 71110, Crete, Greece. markosdaskalakis@yahoo.gr
authors.forename: M
authors.initials: M
authors.lastname: Daskalakis
authors.forename: D
authors.initials: D
authors.lastname: Mavroudis
authors.forename: E
authors.initials: E
authors.lastname: Sanidas
authors.forename: S
authors.initials: S
authors.lastname: Apostolaki
authors.forename: I
authors.initials: I
authors.lastname: Askoxylakis
authors.forename: E
authors.initials: E
authors.lastname: de Bree
authors.forename: V
authors.initials: V
authors.lastname: Georgoulias
authors.forename: J
authors.initials: J
authors.lastname: Melissas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood* / Q000235:genetics; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000097:blood* / Q000235:genetics; D007700:Kinetics; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000378:metabolism*; D011379:Prognosis; D012333:RNA, Messenger / Q000097:blood; D012107:Research Design; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013997:Time Factors
chemical_list: D014408:Biomarkers, Tumor; D053539:Keratin-19; D012333:RNA, Messenger